conscience

Normal & reality: a proposed definition for discussion

On one of the Facebook groups I follow, the conversation about the recent Arkansas law protecting conscience was diverted from the law itself by a sensational headline that reflected only the worst accusations of opponents & the reactions of group members to that headline. 

During the  conversation,  I was questioned about my use of the term “normal” for healthy bodily functions.  At the least, “normal” is that which doesn’t itself injure tissues & organs and doesn’t require technological intervention to produce or to prevent morbidity & mortality.

We are hearing & reading about demands that legitimate research results should be suppressed,  watching physicians and scientists who express heterodox opinions be censored. Then we’re told that there’s a “consensus,”  since none of the “objectionable” research is published, much less popularized, and the outliers are demonetized and covered with warning boxes.

Science  isn’t a “consensus.” In science, true hypotheses are testable,  with valid results capable of being confirmed by different observers under similar conditions in different labs. 

That’s also a good definition of reality or “normal.” One that  could be applicable to medical subjects like COVID or vaccines, as well as social and legal  matters.

We’re  being manipulated for reasons that have nothing to do with actual health, physical or mental.  I can’t fathom a reasonable explanation. It looks like an exertion of power – social, financial, then legal.

Patients won’t be helped at all by forcing moral injury by requiring medical professionals to act against their conscience and we all lose when rational discussion is suppressed in the  public sphere.

To kill or not to kill – or even to call it killing?

It seems that an advocate of Euthanasia and Assisted Suicide (EAS), which is legal in Canada since 2016, complained to the “The Protection of Conscience Project” administrators about their use of the word, “killing,” rather than “Medically Assisted Death” (MAD) when writing about the law. The wording of the objection exposes the potential limitations even on thoughts, much less the act of refusal, of physicians who object to participating in EAS.

End of life or end of hospital stay?

What a tragic story!

While I only know what I’ve seen online, in my experience, it appears that the dispute about Mrs. Carolyn Jones is over continued hospitalization at this hospital, versus transfer to care at another facility.

(See this television news report.)

I’m the first to say that hospitals are scary places and to sympathize with families struggling to cope with the bureaucracy and protocols. However the current news, press releases, and pro-life blogs are reporting several errors and omissions about Texas’s law and legislation up for consideration in Austin.

The obvious errors in this report include:
1. First. It’s not correct that Mrs Jones will die on Monday, even if the ventilator is turned off at the hospital. She’s not intubated through the mouth or nose. Instead, there’s a tracheostomy and a feeding tube in place. Supplemental oxygen could be provided many different ways, at home or in a nursing home.
2. Mr. Jones has testified at the Texas Senate Health and Human Services Committee meeting (EDIT: the video is here, at 52 minutes in) on 4/10/19 and elsewhere that Mrs Jones had been weaned off the ventilator, needing it only occasionally, at night.
2. She should be able to speak and swallow with training.
3. Texas Advance Directives Act doesn’t require that the doctor declare the treatment be “futile.” Instead, the doctor must declare that he refuses to follow a certain treatment decision that the patient or family demands .
4. Kidney dialysis is paid for by the Federal government, so the problem isn’t only funding.

In my admittedly limited knowledge about this particular case – it appears that Mr. Jones disagrees that it’s time to move from the hospital to home or nursing home, even after 5 months (not 10 days).

At least since 2005, legislation has been introduced at the State to increase the timeframe to as long as a month. Texas Right to Life refuses to agree to anything other than indefinite treatment, with the doctor forced to act against his will, violating his conscience and ignoring his medical judgement.

TRTL has even clashed with other pro-life organizations and Texas’s Catholic Bishops and “primaried” several conservative Legislators, although they are the only Texas pro-life group that opposes the law.

It would be good to add more time – I don’t know of anyone who disagrees. But there needs to be a limit to how long a doctor is forced to act against his conscience. One Bill that was rumored this year would change the “10 days” to 21 days and add a week to the notification period before the Ethics committee meets. Unfortunately, it never got past the Powers That Be.

For more on the ethics of the Texas Advance Directives Act, see this WingRight post.

The most urgent need is communication with families, correcting misunderstandings like those outlined here.

(Edited May 10, 2019 at 12:22 AST, to correct the Link to the testimony of Mr. Jones. BBN)

Emergency: Liberty Right Infringement

Texas Right to Life General Counsel Emily Cook is attacking Texas Medical Association on Facebook, even though virtually every other pro-life, medical, nursing, hospital, and disability group in Texas oppose SB 2089 by Hughes, that would change the “Texas Advance Directive Act, “TADA” will harm patients and attack the right of doctors to refuse to act against our conscience.

We’ve worked to fix other problems: Artificially administered food and water, even full IV feedings, can‘t be removed. Texas law didn’t even mention DNRs, but last session, we passed an amendment with explicit procedures and informed consent language.

SB 2089 specifically says anyone can file a lawsuit in any Court in the County, the Court can’t charge the patient (or surrogates) any fees, and the judge is required to rule in 5 days.

Another kind of lawyer joke

“[T]he doctor/bioethics committee thinks the patient should die.” Wesley J. Smith, Esq., Texas Senate Health and Human Services Committee, 4/10/2019 LifeNews.com

Wesley Smith is a rarity among the many lawyers who chased bioethics to the bedside late in the last century: he actually believes in the sanctity of human life and in the right of conscience. I’ve attended and reported on his debates and encounters with proponents of intentional euthanasia. And even happily defended him.

Unfortunately, Lawyer Smith was not above spinning the truth this month when he came from California to once again misrepresent the Texas Advance Directive Act (“TADA,” “the Act,” or “166.___”), an attempt to balance conflicting rights when doctors disagree with a patient or his surrogates about actual medical procedures and treatments that the doctor believes harms the patient.

On April 10, 2019 Mr. Smith gave invited testimony to the Senate Health and Human Services Committee in favor of SB 2089 (Hughes) and
SB 2129 (Creighton). LifeNews.com published part of his testimony online, under the title, “Texas Rule Allows Hospitals to Essentially Euthananize Patients After a 10-Day Notification.”

Mr. Smith doesn’t just contradict multiple Supreme Court rulings since Cruzan (1990) affirming that withholding or withdrawing treatment is not equivalent to euthanasia. Paradoxically, he echoes arguments that anti-conscience activists use to justify abortion on demand, Physician Assisted Suicide and intentional euthanasia by a third party by claiming that the principle of autonomy supercedes “First, do no harm,” or non-malevelence, and the right to conscience.

(You can watch all of Part I and Part II of the April 10, 2019 Health and Human Services Committee meeting addressing SB 2089 by Senator Bryan Hughes and SB 2129 by Senator Brandon Creighton online. Part I includes Mr. Smith’s testimony beginning at 33:00/1:01:10.)

We’ll skip Mr. Smith’s assertion that there is a right to force others to provide everyone medical care in general, not just in emergencies or at the end of life. I’ve covered these assertions and his attacks on the Texas Conference of Catholic Bishops I’m, back in 2007.

Today, let’s just look at his spin on the current version of TADA.

Lawyer Smith uses emotionally weighted terms that aren’t in TADA, such as, “life-extending,” “futile care,” “permitting the institution to force its will on patients and families,” “invidious discrimination,” and “inappropriate care.” He contrasts patient’s “rights” with doctor’s “values,” and is the first that day to raise the specter of doctors willing to kill when patients are “expensive.” And, reflected in the LifeNews.com headline, Mr. Smith flatly says that TADA allows euthanasia – intentional acts to kill patients – equivalent to the administration of injections or medications that he wrote about this week.

As I’ve stated so many times in past WingRight.org and LifeEthics.org posts, TADA doesn’t allow us to remove or withhold care for patients, only treatments that are “medically inappropriate.” There are no futile patients, only futile treatments that cause harm to the patient over and over, without any expectation of reversing organ failure after organ failure.

Mr. Smith also ignores the multiple attempts by the medical and pro-life community and Legislature to improve the law’s timeframe and communication, much as Senator Creighton’s Bill. One example from 2007, SB 439 by Senator Bob Deuell, would have required written notice and an offer of a private ethics consult to take place at least seven days before the hospital committee meeting. That Bill had a schedule for giving the patient or surrogates written information about the dispute process, copies of medical records, and lists of resources. The family would have been given access to the committee meeting, with their own advocates. When the committee agreed that the treatment requested was inappropriate, the family would have receive assistance in searching for7⅞ another doctor or facility for at least another 21 days. I believe that the Bill bogged down in the House because of opposition from Texas Right to Life to any Bill that did not include liability for doctors and the indefinite “treatment until transfer” in this year’s SB 2089.

In the last five minutes of the Part I video, another lawyer, Texas Right to Life General Council Emily Cook, gave us the best clue about the ultimate goal of her organization: “judicial review.”

Ms. Cook and Mr. Smith would have every one of these disputes settled by a Court. This is the Texas trial lawyers’ dream: a huge weapon against our State’s tort reform.

Today, the law specifically allows an appeal to a County probate judge when the Committee agrees with the doctor’s decision. SB 2129 allows a request for an injunction in any Court in the County, enabling “judge shopping.” Since it also prohibits the County from charging the patient or his surrogates any fees, the costs would fall solely on the County.

Ultimately, SB 2129 would make it much, much easier to sue the doctor and the hospital, moving Medical decision-making into the courtroom.

Most of the “stakeholders” for patient rights in Texas (including Texas Alliance for Life, Texas Baptist Christian Life Commission, Coalition of Texans With Disabilities, Texas Medical Association, Texas Hospital Association, Catholic Hospital Association, Texas Nurses Association, and the Texas Conference of Catholic Bishops and many others) oppose both of the Bills that Mr. Smith favored. Since SB 2129 would mandate that the County pick up any Court costs and that the judge make his ruling within five days, don’t be surprised if we hear objections from representatives of these parties, too.

So what’s the “joke?”

It could be the ridiculous notion that Lawyer Smith is a mind reader, able to discern the “invidious” motives for the “discrimination” he feels doctors and hospitals routinely practice:

“To fully comprehend the unjust nature of Texas law in this regard, realize that these “futile care” or “inappropriate care” decisions do not terminate treatment because it won’t work, but because it does. It is keeping the patient alive when the doctor/bioethics committee thinks the patient should die.” (Emphasis from LifeNews.com’s transcript.)

He repeatedly comments that physician’s decisions about medically appropriate treatment are subjective and that they (we) might “project their fears and their desires onto the patient” based on our “values,” rather than medical judgement based on repeated, at least once a day examination of the patient, reports by the nurses and staff and our education and experience.

The joke might be that Lawyer Smith volunteered that the indefinite, repeated evaluation and medical decision-making against the medical judgement of doctors would not be “slavery.” I would like to know what Lawyer Smith calls the legal requirement to use one’s body and brain to carry out actions, including writing orders for nurses and other medical staff, against your will.

It might be tragically funny to watch “judicial review” end up with the two sides hiring expert witnesses – doctors – to give the judge opposing views. There’s dark humor in the realization that ultimately the judge would order the original doctor to use her medical judgement to provide treatment – against her best medical judgement.

But the real joke is that “judicial review” risks the unintended consequence of decisions made by judges like the late t Judge George Greer, who Mr. Smith wrote about in this article.

Comments are closed. Please comment on my Facebook page.

Texas Advance Directive Act 2019 Legislature

“(22) in complying with the procedures outlined in Sections 166.045iand 166.046, Health and Safety Code, fails to make a reasonable effort to transfer a patient to a physician who is willing to comply with a directive.

Amendment No. 5

Representative Toth offered the following amendment to Amendment No. 4:

Amend Amendment No.4 by Toth to CSHB 1504 on page 3, line 25, between “Code,” and “fails”, insert “willfully”.””

Transgender First Principles

This weekend, the debate concerning the ethics of medical and surgical intervention for transgendered men and women, more properly called “gender dysphoria,” heated up again. The New York Times published an essay by a man who wishes to become a woman so much that he is about to undergo a 6 hour surgical procedure to fashion an artificial vagina, although the author admits that the surgery may not produce happiness and, indeed, will most certainly cause lifelong pain and the necessity of further intermittent, painful procedures.

In answer to my assertion (in an online private group) that transgender ideation is a pathology, a pediatrician said that I might as well claim that being black is a pathology.

While I’ve never heard of a black person seeking medical or psychological treatment to make his body more or less in concert with his race or body image ( or maybe I have..), there has to be some perception of a problem on the part of the transgendered person who seeks intervention.

Back in the’90’s, when I was in medical school, the definition included a lack of pleasure from the “wrong” genitalia. While it appears that this requirement for intervention has gone by the wayside, at the least, gender dysphoria makes leading their lives difficult. This seems to be a fair, if simplified, definition for “disorder.”

In addition, one of the early leaders in the development of surgical procedures for trans persons, Dr. Phil McHugh, agrees that transgender ideation is a “Pathogenic meme.”

The fact is that the treatments sought or offered are based on biologic sex and are essentially bimorphic: MtF (Male to Female), FtM (Female to Male). The treatments themselves are described as “feminizing” or ” masculinizing” – one or the other.

The incidence of transgender ideation in the US is less than 1% (probably about 0.5%), with as many as 80% of those who claim to be transgendered in childhood “desisted,” changing their minds at a later date, usually around puberty.

The known association with autism
and schizophrenia, along with the “clusters” of peer-group rapid and late onset, as well as the rate of reversals, suggest caution when it comes to treatment that might later be considered disfiguring and permanent.

The author of the NYT piece states that the traditional “First Principle” of medical ethics, “First, do no harm,” is only a way for doctors to be “little kings” who deny what patients “want,”

“”Nonmaleficence is a principle violated in its very observation. Its true purpose is not to shield patients from injury but to install the medical professional as a little kings of someone else’s body.””

If doctors truly forget the First Principle, what’s to stop us from “First, doing harm?” Who decides the “harm” in that case? Better hope we don’t give up our consciences.

Certainly, in this case, I would be one of those “little king” doctors who would not carry through on surgery, based on what appears to be atypical reaction to the cross-sex hormones.

Just as it’s malpractice to affirm the anorexic girl’s body image as correct and help her avoid food, it’s unethical to pretend that transgender ideation is normal or even something we can “affirm.”

Please comment on my Facebook page, Beverly Nuckols.

Response to criticism about Texas Advance Directive Act

I’ve been having a long Facebook discussion with representatives of organizations, people who claim that I support coercion and killing patients because I defend the Texas Advance Directives Act, 166.0046. (TADA).

I want to respond as fully as I can. ( I’m bandwidth deprived today and will gradually add more links when I reach better signals. See here, here, and here for more explanations from earlier WingRight posts. Links to the law, the press, and previous blog posts by others can be found in those articles.)

It

(Edited 03/11/18 for typos, to add a link, and to clarify points originally made on Facebook in a long debate. BBN)

Rough pro-life waters (#weshootourown)

Calling allies “cancer” and divisive is about as malignant and divisive as it gets!

Mark Crutcher and Troy Newman have co-authored a blog piece over at Life Dynamics that does exactly what they accuse others of doing. They manage to insult sidewalk counselors and Crisis Pregnancy Centers and groups like New Wave Feminists and And Then There Were None. Add in the dark graphics and the sanctimonious, unyielding tone to the accusations, and it’s no wonder our movement hits wall after wall.

What differentiates these two from their designation of “Grandstanders?” Talk about your purity test! 

My instinct as a proponent of “Can’t we all just get along?” was to remember my Mama’s advice: if you haven’t done the bad things they talk about, the scolders aren’t talking about or chastising you. 

And let’s face it, there’s a kernal of truth there: some people are all about power and fundraising and we’ve got to continually educate both new and old activists to focus on our goal of ending abortion.

However, Crutcher and Newman go too far to be too specific and don’t give any consideration – much less kudos – for the possibility that there are effective exceptions within the groups.  While I could point out examples of each of the people they describe, I can easily name more exceptions.

Instead of the negative analogy to cancerous growths, I prefer the picture drawn by my friend, Joe Pojman, PhD., of Texas Alliance for Life. 

Think of our pro-life efforts as attempts to rescue the unborn and their mothers from the sinking ship that is legalized elective abortion. We each have a boat which we use to make trips to bring as many to safety as we can. Every boat is different: Some boats are old and leaky, some are a bit nicer or newer,more or less efficient or are captained by people who wander around a lot and keep making detours, but none of the boats that we have today is big enough or fast enough to save everyone, so we make trip after trip as fast and efficiently as we can. If some of our sympathisers spend time on the shore shooting holes in everyone else’s boat – or anyone else’s boat – fewer lives will be saved. That’s real “mission drift.”

But we can bail water and plug those holes if they’ll just give us a chance.

Clichés are repeated because they prove true, time after time.  Remember this one: “The enemy of my enemy is my friend.” But do we really “educate” with wide condemnation of the efforts of others who approach our goal from a different angle or do we create more of the very harm we are warning about?

Keep building those coalitions, looking for common ground, and plugging along!

Personhood “TBD” 

“To Be Determined,” or the Schrodingder’s cat* version of human rights.

Does the possession of inalienable human rights depend on unknown future facts? Can the moral worth of a human being be determined by the actions of another human being – or by fate, the available and utilized medical technology?

Sherif Girgis discusses the theory of Princeton philosopher, Elizabeth Harman, in today’s Public Discourse. The professor’s view that abortion is – or may be – a neutral act has been the subject of discussion since she appeared in the YouTube video, Philosophy Time, produced by actor James Franco and Eliot Michaelson.

Besides the obvious problems pointed out by Girgis of defining “consciousness” and the TBD “kind” of a human fetus, there are other problems.

First, any concept of “inalienable” human rights would need to be discarded. There goes the Declaration of Independence and the basis of the United States Constitution.

In addition, Professor Harman’s theory would presumably allow the use of bodies of the human species for the benefit of humans with “moral worth,” as long as those bodies are never allowed to become conscious. This is the current practice of researchers using embryos, including those created for the purpose of manipulation and destruction.

But there’s nothing in this philosophy to prevent the intentional manipulation of a human body for research or to benefit others, as long as the body is never allowed to develop consciousness. Continual sedation or mutilation of the brain from the beginning – before consciousness – would prevent the development or acquisition of moral worth and rights.

In the process, “human” rights would cease to exist. The actions of others, laws and location and the potential use of technology would finally determine who is human enough to possess the right not to be killed. (Forget the right not to be “enslaved.”

What happens if (as Girgis proposes) the abortion itself is aborted or fails? Or if the brain isn’t damaged sufficiently to prevent consciousness?

Forget about opening the box: don’t put humans in there in the first place.

*I saw this analogy on a Facebook thread, but thought the same thought before I stole it.

Edited to correct my misspelling of Dr. Harman’s name.

Science vs. Philosophy

R(obin) Alta Charo has once again been given a platform in the New England Journal of Medicine.

Poor Robin. She conflates ethics and philosophy with science. Although observing what “is” can lead to insight about which actions and manipulation lead to harm and which improve individual and group well-being, Science cannot prove or disprove philosophy, or determine what we “ought” to do.

Ms. Charo continues her career-long advocacy for elective, interventional abortion and against the inalienable human right not to be killed – all in spite of her assertion that she has no conflicts of interest in this essay. By declaring that Trump Administration appointees “embrace alternative science,” Robin makes her own gross scientific error. In addition to confusing “science” and philosophy, she bases much of her objection on an emphasis on “established pregnancies” and ignores the existence of the human embryo after fertilization but before implantation.

The very odd complaint about definitions of gestational age assumes that time varies according to when we start counting days.

Some state legislatures have tried to redefine pregnancy dating, shifting from the standard measure of time since last menses to time since probable fertilization. Such a definition falsely enhances the viability statistics for lower gestational ages and helps to bolster arguments for 20-week limits on abortion rights.

Again: Science is about what 《is,》 while ethics ought to be, not about true  《oughts.》

Modern opposition to germ theory???

Why is it that a CPA is trusted to tell the “truth” about vaccines, but doctors aren’t? Perhaps, because doctors understand the science behind the germ theory, learn to read and evaluate the medical literature, and aren’t willing to give credence to doctors who have their licenses restricted or stripped for fraud, much less herbalists who teach that the earth is flat.

In discussions about vaccines with people who oppose them, I’ve been told that vaccines haven’t been subjected to large, “properly,” controlled tests. Even when I pointed to large, controlled, blinded, and randomized studies the answer was that these weren’t the “properly” controlled tests.

This is what they’ve been taught by people like Ty Bollinger, a CPA who has made his living blaming sinister global government chemtrails and, of course, doctors and vaccines for cancer, autism, allergies, and all sorts of other health problems.

The latest Bollinger video series, “The Truth About Vaccines” was evidently promoted on Facebook in April, but I missed it.  I won’t link to the video, but if you want, you can Google it and find episode 1 for free on YouTube. Don’t pay for it!  I’ve watched all 1 hour, 57 minutes, and have been doing research on the “experts.”

In this episode, Bollinger interviews parents, doctors, lawyers, lawmakers, activists and some of the most notorious contemporary doctors: Andrew Wakefield, who had his license revoked for real, intentional fraud in the United Kingdom, and Rashid Buttar, DO, from North Carolina, who is no longer allowed to treat children or cancer patients. And then, there’s the blurb from David “Avocado” Wolfe, an herbalist who denies that the Earth is round or revolves on its axis around the sun!

Pediatrician Laurence Pavlesky, MD,who is prominently featured in the video, doesn’t define the characteristics of a “proper” study in the video, he does in another interview,

“What’s missing in these data is a population of healthy people who have not had any flu symptoms – to actually see if their noses contained H1N1 – because if someone is sick and has the presence of an H1N1 virus in the nose, it doesn’t mean that the H1N1 is causing the illness.

“You really have to take an appropriate control group to see if people are colonized with that virus even when they’re not sick. “

http://articles.mercola.com/sites/articles/archive/2009/11/14/Expert-Pediatrician-Exposes-Vaccine-Myths.aspx

So do docs have to match stroke or heart attack victims with healthy controls, to prove that the controls have no lesions in order to prove that occluded vessels caused the lack of brain function or heart function? 

It’s well-documented that some people are chronic carriers of strep, but not sick. Typhoid Mary was colonized, able to expose others who got sick, but not sick, herself. We also know that the incubation period varies.

Okay, maybe we could get over the difference of opinion about “proper” controls. Or whether the earth is flat. Or even why a CPA and lay people are capable of learning the truth about scientific knowledge, but doctors aren’t. However, another theme often repeated by Pavlesky and other “experts” prominent in Bollinger’s video is the denial of the germ theory.

Fom Pavlesky’s “General Guidance”:

“The expression of these symptoms may not always be caused by infections from bacteria and viruses. Instead, these symptoms and illnesses may develop as a sign that our children are healthy; that their bodies are strong, and working to bring to the surface, and cleanse, any accumulation of wastes that are deep inside them, having accumulated due to their exposure to varying stressors in their lives. In many instances, the process of bringing these wastes to the surface of the body is aided by the bacteria and viruses already living inside of them, and is a necessary step for them to become well.”

Sheri Tenpenny, DO  is another doctor in the video. On her blog, she also promotes infections as a good way to get rid of  “toxins,” adding,

“As contrary as it seems, germs are attracted to the diseased tissues; they are not the primary cause of it.”

Here’s a little statement from me:

*The diseases we call infections are caused by infectious agents: bacteria, viruses or parasites​.* 

If we can’t agree on this (and that the earth is not flat), we have no common ground for a logical discussion about Western medicine.

More to come in later posts about the “experts” in the video.

Law makers to doctors: “Keep the patient alive” 

If only we doctors – or legislators, lawyers and probate judges – really had the power to “keep the patient alive” as this article claims two new Bills  (  HB 4090 & SB 1213) in front of the Texas Legislature will (force doctors to) do. 

The article is misleading in its claim that a committee or a hospital decides whether or not a therapy is given: Texas doctors practice medicine in Texas. Even the Bills make it clear that the “attending physician” makes the decision whether or not to follow the patient’s (or more likely, the surrogates’) medical request.

We – Texas doctors, hospitals, and legislators – have tried repeatedly over the last decade to amend the law, Texas’ Advance Directive Act,   to increase the time frame. Last Session, we helped to ensure that food and water can’t be withheld. The lawyers and those who would have Estate (probate) judges involved in every dispute – even at the bedside of the dying – have blocked effort after effort because the Bills did not include liability for the doctor. 
These Bills are just the camel’s nose under the tent of Texas’s tort reform. Worse yet, we’d end up with medical expert testifying against medical expert in court, with the judge eventually telling the doctor how to practice medicine. It would also severe the “ethicists” who actively seek to undermine conscience protections for health care professionals.
If you’ll notice, the Bills also remove the requirement for the patient to pay for any transfer, too. I don’t suppose that the tort lawyers ​will pay for the ambulance or plane ride.

Do you want Texas law to force doctors to practice against our consciences​? 

How long and how far should any man or woman be forced by law to act against his or her will?

I hope you can recall this

The future includes so much more than a 10 year old video, for people who don’t have memory problems.

Forget the Clinton’s sale of nights in the Lincoln Bedroom and misplaced furnishings from the White House and, later, the State Department offices. Go ahead, laugh at the “Reset button.”

But don’t forget the pay-for-access that continues to this day. Please don’t dismiss Clinton’s complicity with the sale of US uranium and her own dismissal of the deaths of four Americans at Benghazi or of “our posterity” in the case of the unborn children whose lives are ended by elective, intentional abortion.

These recollections make a difference today and for the future.

What place will there be in a Clinton II Administration for people who oppose abortion or who prefer to continue to include “under God” in the Pledge of Allegiance? Can we tolerate another 4 years of IRS discrimination against conservative non-profits? Do we need to have more lawsuits against nuns or regulations forbidding Christians from praying in the name of Jesus?

We certainly won’t be invited to any closed door meetings on HillaryCare. And there’s no telling how many boxes of FBI files and billing records will disappear never to be “recalled” if Clinton gets another shot at the White House.

I would much rather hold Donald Trump to his promises than watch Hillary Clinton keep hers.

Beverly B Nuckols, MD

Trust me, I don’t have a conscience (yes, THAT again)

Speaking of CS Lewis’ “conditioners” in my last post, a small group of “philosophers and bioethicists” got together in Geneva, Switzerland last June and came up with a “Consensus Statement on Conscientious Objection in Healthcare.”

On the “consensus” from less than 20 self-selected individuals, we’re supposed to advocate the move from shaming doctors for objecting (to acts that have been considered shameful by Western society since Hippocrates) to some sort of judgment by tribunals.

From the BioEdge.org blog:

“After a special workshop held at the Brocher Foundation in Geneva, Switzerland, over a dozen bioethicists signed a ten-point“Consensus Statement on Conscientious Objection in Healthcare.” The group stated that “healthcare practitioners’ primary obligations are towards their patients, not towards their own personal conscience”. As a consequence, “healthcare practitioners who are exempted from performing certain medical procedures on conscientious grounds should be required to compensate society and the health system for their failure to fulfil their professional obligations by providing public-benefitting services.” They also stated that “Medical students should not be exempted from learning how to perform basic medical procedures they consider to be morally wrong.”

What’s to enforce those guidelines if the physician has no conscience? What place does “should” or “ought” – words that are flung about in the “Consensus” – have if the conscience is to be dismissed?

As Wesley Smith points out  at his blog on National Review, any objectors would be re-“conditioned.” The “Consensus” demands that  doctors not only be forced to explain their rationale, perform “public-benefitting services” (in addition to their jobs as doctors), and teach medical students those morally controversial procedures, they would be sent to re-education classes.

Oh, and they might not be able to get a job in the first place if they aren’t morally pure – excuse me – able to “fulfil (sic) their professional obligations,” according to this little club:

“This implies that regional authorities, in order to be able to provide medical services in a timely manner, should be allowed to make hiring decisions on the basis of whether possible employees are willing to perform medical procedures to which other healthcare practitioners have a conscientious objection.”

I sincerely doubt that any representatives were invited – or allowed – to attend. (At least, that’s my experience.)

More on “conscience” by searching the “Categories” on this page.

Truth and Conscience #SJWs

​Timely still, this essay by CS Lewis on “subjectivism.” Please watch the last few minutes – from about 10:30 in – if not the whole 13.
Lewis asserts that the idea that “good” can vary or is a product of evolution or conditioning will ultimately lead us to a society divided between the “conditioners” – eugenicists, (capital s) State educators,  and producers of mass propaganda – and the conditioned.

Those conditioners sound like our community organizers and progressives, who, in denying the time-tested absolute, ” self evident truths – while demanding that we accept the latest declaration of the “Social Justice Warriors” as . … absolute, self evident truths. 
While questioning the validity of any authority in order to demote conscience to opinion, they assume authority and invoke the conscience of the conditioned to enforce compliance.  How often do we find ourselves shamed  for objecting to actions that have been considered shameful for thousands of years by nearly every society on earth?
And since the SJWs (or their conditioners) de- and re-construct “truths,” their own consciences allow them to believe that they and their allies aren’t bound by the same “truths” that they hold the rest of us to. 
So, the next time yo find yourself the target of ethnic/gender/social conditioners for expressing truths that Aristotle, Hippocrates, the signers of the Magna Carta or the Declaration of Independence –  or even Jesus – would have recognized as self evident, turn their argument back on them. What is their authority, where is their evidence and how valid is it?

Death, lies and video

Death, lies and video

Supported only by his imagination, what he saw in videos produced by Texas Right to Life lawyers, and a news article,Dr. Phillip Hawley, Jr., M.D., wrote “A Tragic Case of Modern Bioethics; Denying Life-Sustaining Treatment to a Patient Who Wanted to Live” about the truly tragic, but inevitable death of Chris Dunn. Hawley erred by pretending to read the minds of doctors and hospital representatives and calling complete strangers “utilitarian” “murderers.” Before discussing the ethics of his accusations, it’s necessary to explain the meaning of the documented facts, available in news sources, blog posts and court records:

1. Dunn was not “alert and cognizant” as he had documented delirium secondary to hepatic encephalopathy and over a month on the ventilator with sedation and pain meds
2.  The hospital voluntarily, without a court judgement, promised to continue life-sustaining treatments in place until the legal guardianship question was settled.
3.  Food and water, legally termed as “Artificially Administered Nutrition and Hydration” or AANH and including total parenteral nutrition, cannot be removed against the objection of patients or surrogates, under Texas law.
4. The doctors stated that they believed the “life-sustaining treatments,” were causing suffering.
5. The hospital never sought guardianship for themselves, only for “a qualified family member,” and listed their names and locations in the original petition.

It is very unlikely that Chris understood his condition, the questions the lawyers were asking or the consequences of his “prayer.” That he was unable to make medical decisions is supported by the fact that his parents had been making his medical decisions. The Harris County judge agreed with the hospital’s request that a single legal guardian be named by a separate court.
“Life-sustaining treatment,” “medically inappropriate” and “Artificially Administered Nutrition and Hydration” are legal terms defined in the Texas Advance Directive Act (TADA), which outlines the exact procedure and language for communications between doctors, the hospital committee, and patients or their surrogates. The use, monitoring and adjustment of a mechanical ventilator is in the definition of “life-sustaining treatments.” TADA specifically excludes “Artificially Administered Nutrition and Hydration” (AANH) in the definition of “life sustaining treatments,” which would argue against the accusation that his doctors planned to withdraw “food and water.”
The only legal reason under TADA to remove any “life-sustaining treatment” is that it is deemed “medically inappropriate” by the attending physician and then only if the hospital medical or ethics committee “affirms” that decision. If and when they are withheld, the Act specifically prohibits “mercy killing” or otherwise intentionally intervening with the intent to cause death by artificial means.
Additional demands by Chris’ mother, Mrs. Kelly, and the lawyers in blogs and news articles would have also fallen under the legal definition of “life-sustaining treatment.” These demands included a biopsy in order to determine a definitive tissue diagnosis for the clinically apparent pancreatic cancer and liver lesions, a surgical tracheostomy and the removal of the ventilator (to be fair, I believe they meant the tube through the vocal chords), less sedation, searches for and trials of treatment of the cancer, and the non-standard use of an indwelling drain for the ascites (large exudates in the abdomen due to high pressures in the liver and the failure of the liver to make necessary proteins). These are invasive, potentially painful and, based on the reported size and effects of the mass, the extent of liver damage visibly evident in the videos as temporal wasting and copper-colored skin, ascites and the GI bleeding – they were very unlikely to lengthen his life, much less cure his cancer. In fact they could be very likely to hasten – or be the immediate cause of – his death.
Chris died in the ICU on full life-sustaining treatments, including the ventilator and intravenous AANH.
The doctors are on record as basing their decision on the suffering caused by the treatments to their patient, Chris. This is consistent with the known side-effects of the ventilator and even reports from Chris’ mother, who told reporters that Chris suffered from the treatments and fluid building up in his lungs despite the ventilator. And yet, Dr. Hawley made sensational statements such as:

“For patients with terminal illnesses, this standard often leads to the utilitarian question: Is the patient’s life still worth living?
“In Chris Dunn’s case, the committee’s answer was “no.” Relative strangers with little or no knowledge of his values and beliefs weighed his “quality of life” and decided that he no longer deserved to live.”
And,
“. . . How did these committee members who had only recently met the patient—if they ever met him at all—know that it was in his best interest for them to end his life?”
And,
“. . . But, somehow, we are to believe that these committee members were able to deduce existential truths about what was in Chris Dunn’s best interest?”

The physicians who cared for Mr. Dunn for over a month had certainly met him and members of the Methodist Hospital Biomedical Ethics Committee met with the family several times. Court documents are clear that the doctors believed the life-sustaining treatments were causing suffering and that the committee agreed that the treatments were medically inappropriate. There certainly is no evidence that the doctors or the committee members sought to intentionally “end” Chris’ life. “Medically inappropriate treatment” is not an “existential truth” and never in the patient’s best interest.
(Some may remind us that suffering can have benefits. However, Mr. Dunn couldn’t consent to suffering, much less benefit from the suffering, whether as a medical treatment or a willing religious self-sacrifice.)

Robert P. George is one of my heroes a conservative tenured professor of law and ethics at Princeton and one of the founders of the Witherspoon Institute, an organization known for its defense of Judeo-Christian ethics based on natural law, and the parent organization of Public Discourse. He has helpfully outlined a “key” to evaluate the withholding or withdrawing of life-sustaining care:

“[T]he key is the distinction between what traditionally has been called “direct killing,” where death (one’s own or someone else’s) is sought either as an end in itself or as a means to some other end, and accepting death or the shortening of life as a foreseen side effect of an action or omission whose object is something other than death—either some good that cannot be achieved or some evil that cannot be avoided without resulting in death or the shortening of life.”

George and Hawley each point to a value in medicine that is higher than autonomy or even preserving life at all costs: the duty of physicians to care for the patient. “Cure when possible, but first, do no harm.”
The lawyers didn’t just sue to maintain “life-sustaining treatments,” or even Mrs. Kelly’s right to force the doctors to treat Chris the way she wanted them to. The lawsuit, blog posts and public statements document the ultimate goal to have TADA declared unconstitutional and to force all doctors to give patients and surrogates the right to demand any and all desired treatment indefinitely. The power of State courts, law enforcement and licensing would be used to force Texas doctors to carry out acts against our medical judgment, education, experience and conscience.
What justification can the lawyers and Dr. Hawley give for not believing the physicians who care for patients daily and hourly when those caretakers document that the patient is suffering?

What kind of physicians will we end up with if the State can force us to act without judgement or conscience?

What kind of State would we have?

Based on a video and his imagined conversations between “malevolent” and “utilitarian” doctors and hospitals, Hawley declares Texas a “morally impoverished society.” Ignoring sworn statements from the physicians and misrepresenting TADA, he distorts the purpose of the Texas Advance Directive Act, which is to address the problems encountered when patients and surrogates disagree., Only by assuming evil intent is he able to force doctors to prove a negative and distract from any possibility of a conflict between the equal and inalienable rights of the patient and the doctor.

While the video of Chris apparently praying to be allowed to live wrenched at our emotions, it was used to tell a false story upon which Dr. Hawley built his harmful assumptions. We would all do well to remember my Mama’s advice: Don’t believe anything you hear and only half of what you see.”

Edited for grammar and decrease wordiness and formatting (1-15-16). BBN

Don’t believe the lies!

And stop “sharing” them!

Remember who the real opponents are: the Dems!

No matter how juicy the gossip, consider waiting a few hours for the rest of the story to come out.

(BTW, this is a test of my mobile app.)

Posted from WordPress for Android. Typos will be corrected!

Independence or slavery: Does the government own you?

Let’s face it: if the government can tell you that you cannot refuse to act, the government owns you.

Liberty is not simply the freedom to act, it’s the more fundamental freedom not to act. Remember the proverb that “The right to swing your fist ends at the tip of my nose?” True liberty includes the right *not* to make a fist at all. To force the hand of a person against his will other than to defend the higher-priority right to life is to enslave him.

The same sex marriage ruling and protected status for “sexual orientation” is the latest socialist infringement on the inalienable right to liberty. In the name of “equality,” “fairness” and even “liberty,” they attempt to give government the ownership of all property and the means to earn it.

In particular, they demand that people of conscience either deny their faith or get out of government and public activities, including business and earning a living. (For real life examples, read the earliest few comments, here.  Or here.)

People who want what they want, when they want it, and from whom they want it seem to have no problem forcing other citizens to act against their will. In order to devalue the right of conscience and religion they deny the rights in the First Amendment of the Constitution – or the very existence of inalienable rights at all.

The Board of Labor of Oregon just gave us a perfect example just this week. Brad Avakian, the judge in the Sweet Cakes Bakery case, has slapped the couple with a gag order.  He would deny them free speech as well as the free exercise of their religion.

Here’s the justification for that order.

(Thanks to Kelsey Harkness!)

The Supreme Court of the United States, States and local governments cannot create a world of gumdrops and lollipops, where everyone likes everyone and everything they do. There is no right not to be inconvenienced, much less the right not to be offended. The right to liberty of anyone may not be infringed for the benefit of another person’s pursuit of happiness without significant distress to society and government.

Read the Declaration of Independence to see what happens when governments attempt to do so.

Regulate anti-vaccine docs?

We may not ever solve the problem of an irresponsible tabloid press and sensation-seeking media, since the freedom of speech is too important to infringe.  But we do have power over those we license as physicians.

Dr. Walt Larimore enters the vaccine debate in his blog, not by suggesting forced vaccination, only the regulation of physicians. I wouldn’t support the recommendation without some leeway — I’m certainly not going to approve of every vaccine without a time trial in this very diverse lab that is the United States.

However, Dr. Larimore and his guest author, Dr. Russell C. Libby, are right to raise the ethical and medic0-legal responsibility of physicians who are licensed by the State and who advocate against good science and medical standards.

From the article:

“State medical boards must decide if the actions of healthcare practitioners who advocate against vaccination and undermine the public health efforts of their communities warrant investigation and intervention. There are a number physicians and other licensed healthcare professionals who trivialize and discourage immunization, whether it be for philosophical, financial, or self-promotional reasons.

“When the patients they influence contract preventable disease and have bad outcomes or they cause the spread to a vulnerable population, they should be held liable for malpractice. If it is in the midst of an outbreak or epidemic, medical boards need to sanction or suspend licenses.”

 

I’ve spent quite a bit of time — especially over the last week – attempting to educate interested people (including a family member) about the safety and usefulness or efficacy of vaccines.  My motto for these arguments has always been that, “Truth will out,” and, “If we’re right, we should be able to teach and convince.”

However, within the last week, an irresponsible Texas radio host trotted out the discredited and un-licensed doctor who fabricated the MMR/autism fraud and a Canadian newspaper published a hit piece on Gardasil. (You can find them easily on Google – I won’t give them “hits” from my page.)

When licensed physicians – men and women who should know better – spread demonstrable lies, even after being found guilty of fraud or when demonstrably spreading harmful misinformation, there should be consequences.

“How Government Killed the Medical Profession”

Contrast the Hippocratic ethic in which a physician recommends treatment to his patient, based on his best medical judgement in the patient’s interest, with that of the “veterinary ethic,” where decisions are made by the “payor” — or owner. Now, consider the effect of Government regulations which arbitrarily force doctors to learn protocols and guidelines (rather than adjust to the patient’s course of illness), to fit a patient’s illness into International Clinical Diagnoses (out to the nth decimal place) and which withhold payment when a patient becomes ill enough to need readmission to the hospital within 30 days of the last admission.

In an article published online by Cato, Dr. Jeffery Singer lays out the history of the destruction of Medicine as  a profession. In the past, Dr. Singer described the ethical transition toward the “veterinary ethic.”

Each of these articles is worth your time and consideration. The first article gives one of the best explanations of the Government move to “coding” of medical diagnoses in exchange for payment “reimbursement,” on through the forced move to Electronic Medical Records without evidence that patients will benefit and Accountable Care Organizations which assign patients to employee “providers.” The second, earlier article, reviewed the necessary change in medical ethics to allow doctors to practice without – or in contradiction to – their conscience.

Forget patient autonomy, long elevated by the lawmakers, lawyers and  Ph.D’s (in the name of “Bioethics”) above the traditional physician Hippocratic values of beneficence and its foundation, non-maleficence. In the world of Government medicine, your life is in the hands of the “payor:” the Golden Rule of “He who has the gold makes the rules.”

I say “fertilization,” you say “conception”

Forty years ago the words “fertilization” and “conception” meant the same thing to doctors, lawyers, and embryologists alike: the joining of the 23 chromosomes in the sperm with the 23 chromosomes in the oocyte (“egg”) to form a new complete, unique human organism. “Contraception” was defined as any method that worked before the existence of the embryo by preventing fertilization. These were the hormonal treatments and devices that prevent ovulation of the egg and condoms, diaphragms and sterilization that serve as “barriers” between the sperm and egg.   Drugs and devices that may or may not end the life of the embryo after fertilization were legally and correctly called “abortifacients.”

However, legalized abortion and the ability to accomplish fertilization through in vitro methods led to new legal definitions of “pregnancy” and “conception” as beginning at implantation rather than fertilization.   Even in vivo, healthy human embryos in healthy mothers were deprived of legal protection as human beings for at least the first 5 – 10 days of their lives, the window of opportunity for implantation when the developing embryo grows to hundreds of cells organized in 2 or 3 recognizable tissue layers and interact with the mother’s body in ways that may affect the timing of birth or risk of diabetes and other health concerns. Possible abortifacients that work after fertilization but before implantation were redefined as “emergency contraception.”

In spite of what you may have heard on the news, the June 30, 2014 Burwell v. Hobby Lobby decision by the Supreme Court of the United States (SCOTUS) didn’t deny birth control for anyone. Everyone may still purchase his or her own FDA-approved birth control.  SCOTUS simply ruled that the government can’t force some employers to buy things that they believe are immoral.

In fact, Hobby Lobby only asked to be exempt from purchasing insurance plans that paid for specific drugs and devices used for “emergency contraception.” Before the passage of the Affordable Care Act (“ObamaCare” or ACA), the company purchased insurance that included true forms of contraception, including,

• Those that prevent ovulation by preventing the normal ups and downs of the hormones estrogen and progesterone, such asBirth-control pills with estrogen and progestin (“Combined Pill”),Birth-control pills with progestin alone (“The Mini Pill”),Birth control pills (extended/continuous use), Contraceptive patches, Contraceptive rings,Progestin injections, andImplantable rods

and

• Those that act as “barriers” to fertilization by preventing the union of sperm and egg: Male condoms, Female condoms, Diaphragms with spermicide, Sponges with spermicide, Cervical caps with spermicide, Spermicide alone, Vasectomies, Female sterilization surgeries, and Female sterilization implants.

The problem is that regulations written by the Obama Administration mandated that all insurances pay for all pregnancy “preventatives” approved by the FDA, including drugs and devices that may function after fertilization to end the life of the new human embryo:

• Pills that mainly delay ovulation but may impair implantation and development of the placenta if fertilization takes place, such as over-the-counter Plan B and generic levonorgestrel tablets, and ella, which requires a prescription, and
• Devices that mechanically and hormonally make the uterus inhospitable to implantation by the embryo, such as intrauterine devices like the copper-T, Mirena, and ParaGuard. These are inserted up to 5 days after unprotected intercourse to prevent implantation and then left in place to prevent fertilization and implantation for as long as 5-10 years.

Although the words we use do not change the fact that the human embryo is the same human life before implantation as after, they can change his or her legal status.

Understanding Supreme Court Decisions: Hobby Lobby

For questions about the decision and history behind it, read this!

Understanding Supreme Court Decisions: Hobby Lobby.

Wider impact of Hobby Lobby ruling? : SCOTUSblog

Remember, no one is forbidden to buy anything.  However, the US Government will not force people or their companies to pay for devices and drugs they believe are immoral.

 

The Affordable Care Act regulations issued by the federal government, however, required twenty different preventive methods or services, including sterilization and pregnancy counseling. Depending upon how lower courts now interpret the Hobby Lobby decision, companies that fit within the Court’s “closely held company” bracket and offer religious objections could be spared from having to provide any of those services through their employee health plans.

In three cases in which a federal appeals court had rejected the challenges to the mandate, the new Supreme Court orders told those courts to reconsider, applying Monday’s decision. The companies or their owners had taken those petitions to the Court.

On three petitions filed by the federal government, involving appeals court rulings rejecting the challenges by corporations. their owners, or both, the Justices simply denied review.

via Wider impact of Hobby Lobby ruling? : SCOTUSblog.

Protect the Privacy of Your Medical Records |

I’ve had privately insured and Medicare patients – and at least two families visiting our town from Canada – ask me to keep records about one or another history or ailment. I told them I’d do my best, but explained the legal problems with Medicare laws. Since 1997, doctors have been prosecuted for refusing to allow Medicare auditors to see everything in the office. One woman doctor was arrested for refusing to unlock a drawer in her (private?) desk.

And now, the IRS wants control of your medical care.

 

The confidentiality of the medical relationship and records has to be maintained or patients will not disclose the true nature of their problems. This results in harm to the patient and prevents the physician from truly helping the patient.

via Protect the Privacy of Your Medical Records |.

Sen. Deuell challenges Texas Right to Life over “slanderous” ads | Dallas Morning News

Remember: Senator Bob Duell was instrumental in convincing the medical community to adopt voluntary procedures to protect patients and families affected by the Texas Advance Directive Act, even though actual amendments to the law have been blocked by the very people attacking him.

How much “freedom” does a third party Political Action Committee have in their paid ads? Is it wrong to challenge them legally when the ads are blatantly false?

In this case, the ad opens by implying that Senator Duell is responsible for the too-short 10 day period allowed to find alternate care when the family or patient disagrees with the doctor at the end of life.

Senator Duell was not in the Senate when the Texas Advance Directive Act was passed in 1999. Members of the PAC, Texas Right to Life, were present and lobbied in favor of the Act.

In contrast, Senator Duell has for years been a strong advocate for amendments that would have increased the power of families to protect their loved ones in the case of disputes with the doctor.  The amendments would have changed the waiting period to at least a month before any disputed decisions by the doctor would take effect.

As to the challenge, Senator Duell has excellent support for his case:

The Texas Catholic Conference and Catholic Bishops of Texas, who supported Deuell’s bill, have debunked the claims. They said that Texas Right to Life “has tried to stoke fear through ridiculous claims of non-existent death panels and assertions that doctors are secretly trying to kill patients. Both claims are absurd.” The Catholic Conference also ripped Texas Right to Life for spreading “fabrications” about the position of Catholics on the issue.

via Sen. Deuell challenges Texas Right to Life over “slanderous” ads | Dallas Morning News.

More on docs and conscience

Just after posting the article about Great Britain’s new official exclusion of pro-life doctors, I received an email from AAPLOG, the American Association of Pro-life OB/Gyns, referring to this article:

http://www.sciencedirect.com/science/article/pii/S2213560X14000034

“In medicine, the vast majority of conscientious objection (CO) is exercised within the reproductive healthcare field – particularly for abortion and contraception. Current laws and practices in various countries around CO in reproductive healthcare show that it is unworkable and frequently abused, with harmful impacts on women’s healthcare and rights. CO in medicine is supposedly analogous to CO in the military, but in fact the two have little in common.

This paper argues that CO in reproductive health is not actually Conscientious Objection, but Dishonourable Disobedience (DD) to laws and ethical codes.”

Read the rest for more about the “dishonorable doctors” who follow their consciences and well over 2000 years of “First, do no harm.”

Edited: BBN  to add corrected url,

UK: Doctors with consciences not welcome

The Royal College of Obstetricians and Gynecologists in Great Britain have determined that any nurses or doctors who oppose any form of contraception may not complete training and will not receive certification in the specialty:

Doctors who oppose morning-after pill on conscience grounds face qualifications bar

Guidelines confirm that doctors and nurses who oppose controversial emergency contraception on ‘moral or religious’ grounds cannot receive key specialist qualifications

This is very possible in the US. Take a look here at some fairly recent history of attempts to keep docs from practicing with a conscience.

American Academy of Family Physicians resignation

I wrote a very difficult letter today. I  resigned from the organization that is supposed to support Family Physicians in our education, practice management and good medical care of our patients. Instead, the American  Academy of Family Physicians too often strays toward forcing its members to be complicit with controversial policies such as condoning gun control and over-the-counter contraceptive drugs, and condemnation of “reparative therapy” for homosexual patients, even when those patients are unhappy with their sexuality. I write about my main conflicts and the “final straw” in the letter:

 

It is with great regret that I write this letter as notice that I have decided not to renew either my Texas or American Academy of Family Practice membership. While I am still a family doctor, neither the Texas Academy of Family Practice (TAFP) nor the American Academy of Family Practice (AAFP) represent my political or ethical views.

The political, social and ethical controversies were the main reason I remained in the Academy for the last few years since I left full time practice. I hoped that I could make a difference by volunteering my time and money as an active participant in the Texas Academy, the National Conference of Special Constituencies, the AAFP list serves, the Academy Legislative meetings in DC and our annual AAFP Congress of Delegates.

From the time of Hillary Clinton’s closed meetings on healthcare to the endorsement of the passage of the ACA before it was written, the political actions of the AAFP leaders has disappointed me in Washington, DC. Our practice hassle factors have grown and grown, too often with the blessings of – and sometimes due to the experiments with alternative methods of practice by – the Academy.

The AAFP advocated for elective abortion before I joined as a Student member and I accepted that the burden of persuasion was on those of us who disagreed.

However, the Academy’s decision to advocate for the redefinition of marriage in 2012 and the refusal to reconsider the extracted Resolution on marriage neutrality at the 2013 Congress of Delegates in San Diego were the final proof that there’s no tolerance for family doctors who hold conservative politics or traditional ethics in the Academy.

Unfortunately, our TAFP spokesperson to the 2013 AAFP Reference Committee on Advocacy misrepresented the Texas Delegation’s instructions from the Directors on marriage. As I remember the discussion and vote, the intention was to allow the Texas delegates wide latitude in voting on any final form of the Resolution.

I hereby resign from the Texas Academy of Family Physicians, the American Academy of Family Physicians and as a Fellow of the AAFP.

 

I waited to resign after nearly 30-year membership until the last minute before being dropped (for lack of paying my annual dues). There were several reasons for my hesitancy. For one thing, I didn’t want to be an undue influence on other members when they considered whether or not to write that hefty annual check to the Academy. For another, while I will continue to work with the AAFP and the Christian Medical and Dental Association to protect the right to life, marriage, the conscience rights of doctors within the profession of medicine and the specialty of Family Medicine, I do believe that it is important to work to persuade from within the organization. The biggest problem with finally writing the letter was that I was looking for a way to somehow keep my integrity while allowing the Academy to claim to represent me.

However, now that I’ve resigned, please consider sharing my letter with your family doctor. Many of them are unaware of the policies that our professional organizations push on good doctors of today and the students and residents who will be our doctors of tomorrow.

Lies, Damned Lies and “ScoreCards”

It takes a long time to write the hard posts, so I’ve been putting this one off for a while. But with Primary season off and running, conservative groups are turning on conservative legislators and using political “score cards” to attack.

Let’s start with the most manipulated “scorecard” of all, especially now that someone else has stepped up to explain so much better than I ever could.

Texas Right to Life, the organization which was criticized by the Texas Catholic Conference for their “misstatements and fabrications” concerning HB303 and HB 1444, continues to make up whatever they wish, this time with their arbitrary  “Legislative Scores.” Their scorecard is so “Unconventional” and “perplexing” that it prompted the following letter, signed by all the Texas Catholic Bishops:

December 9, 2013

The Honorable Dan Huberty Texas House of Representatives P.O. Box 2910 Austin, Texas 78768

Dear Representative Huberty:

I am writing at the behest of the Roman Catholic Bishops of Texas to share their concerns about a recent “pro-life scorecard” released by Texas Right to Life (TRTL). This “scorecard” purports to declare which Texas legislators are “pro-life” based on a selective number of votes during the 83rd Legislative Session.

Unfortunately, the unconventional methodology and subjective scoring of the TRTL scorecard produced a number of perplexing results–including assigning low scores to pro-life lawmakers who have worked long and hard to protect and preserve life.

As you know, the Texas Catholic Conference does not use scorecards. Instead, our bishops encourage parishioners to fully form their consciences through prayer and education about issues. Scorecards are a poor substitute for that level of thoughtful policy engagement. Perhaps the most faulty implication of the scorecard is that, in its current form, it casts the tradition of Catholic teaching as being insufficiently pro-life–which is a patently absurd notion. TRTL does not have license to publicly define who is sufficiently pro-life or not.

Some legislative scorecards, when created objectively and appropriately, can be informative. If not, they stop being about informing the public and become more about advancing political agendas, with the unfortunate result that some citizens end up being misled about the issues and misinformed about the voting records of their legislators.

The recent TRTL scorecard selected only three bills (and assorted amendments) to calculate the scores out of the thousands of bills considered during the 83 rd Legislative Session. Several pro-life bills were excluded from consideration. For example, the TRTL scorecard did not include or minimized support for bills that would have prohibited abortion coverage from insurance plans provided in the Affordable Care Act healthcare exchanges (HB 997); prohibited sex selection abortions (HB 309); strengthened parental rights to reduce judicial bypass for teen abortions (HB 3243); or criminalized coerced abortions (HB 3247). All these proposals were unquestionably pro-life, yet were not scored equitably on the TRTL scorecard.

As a result of this selective vote counting, several legislators, who have spent their careerscommitted to pro-life issues, were said to “reject opportunities to protect the sanctity of innocent human life” when that is clearly not the case. For example, Senator Bob Deuell was responsible for requiring abortion facilities to meet the standards of ambulatory surgical centers (SB 537)—a key provision of the landmark prolife legislation that ultimately passed during the Special Session. However, the TRTL political action committee gave him no credit for authoring this pro-life bill. In another instance, State Rep. Bill Callegari was given no credit for his authorship of the parental rights bill (HB 3243).

The method by which the scores were assigned was haphazard and confusing. Some legislators were awarded more points than others for the same legislative action, while other legislators’ contributions were completely ignored. For example, Rep. Jodie Laubenberg and Rep. John Smithee both authored pro-life bills during the session, but Laubenberg was awarded 25 points for authorship of HB 2, while, Smithee was awarded only six points for authoring another pro-life bill that sought to remove abortion coverage in the insurance exchanges. In another example, Rep. Tracey King, who voted against both pro-life omnibus bills (HB 2 and SB 5) received a higher pro-life score than Rep. J. D. Sheffield, who voted FOR both HB 2 and SB 5.

Senator Eddie Lucio Jr. was not scored as pro-life, despite his co-sponsoring and voting for HB 2 and SB 5 and twice crossing party lines to be the final necessary vote to suspend Senate rules and debate on these bills.

What was most troubling to the Texas Catholic Bishops was that the scorecard appears to attack those legislators who supported perhaps one of the most pro-life bills during the 83rd session: protecting individuals and families at the end of life by reforming the Texas Advance Directives Act. Advance directives reform not only would have given families more tools to protect their loved ones at the end of life, but would have provided conscience protections to medical providers to refuse inflicting burdensome and unnecessary procedures on patients. The advance directives law would have changed current law to:

 prohibit the involuntary denial of care to critically ill patients, including food and water;

 prevent doctors from making unilateral “Do Not Attempt Resuscitation” orders without consulting families; and,

 require treating all patients “equally without regard to permanent physical or mental disabilities, age, gender, ethnic background, or financial or insurance status.”

The advance directives reform bill was a moral and compassionate approach to end-of-life care that was opposed by TRTL, but supported by a broad coalition of groups, including the Texas Catholic Conference, the Texas Baptist Christian Life Commission, the Texas Alliance for Life, the Coalition of Texans with Disabilities, the AARP, the Texas Pro-Life Action Team, the Texas Conservative Coalition, and the Catholic Hospital Association of Texas. Advance directives reform was important to the Catholic Church–and to many legislators–because we recognize human life as a gift from God that is innately sacred–from conception to natural death. We have taken this position after much reflection to ensure that the law respects the natural dying process.

The implication to be drawn from this scorecard is that TRTL opposed the advance directives reform bill, and appears to have taken to punishing those pro-life legislators who disagreed with them by inaccurately casting them as not being sufficiently pro-life. That is plainly inaccurate.

In the case of the advance directives reform bill, legislators who supported the law were strongly pro-life; they merely opposed the TRTL’s position. These are not necessarily the same thing. It is unfortunate that so many members who continue to fully stand for life are being attacked for doing just that. We hope that this letter has clarified what would otherwise have remained an unfair and confusing characterization.

Sincerely,

Jeffery R. Patterson Executive Director